Associations between Probiotic Exposure and Hepatic Steatosis: A nationwide cross-sectional study

Abstract Background : Recent research showed that probiotics treatment may reduce insulin resistance, regulate lipid metabolism, raise liver enzyme levels, and ameliorate inflammation in individuals with non-alcoholic fatty liver disease (NAFLD). However, the association between probiotic use and hepatic steatosis in people has not been identified. The purpose of this study was to investigate the possible relationship between probiotic exposure and hepatic steatosis. Methods : The cross-sectional research was conducted among adults with complete data on probiotic exposure and hepatic steatosis in the 2011-2016 National Health and Nutrition Examination Survey (NHANES). Probiotic exposure was assessed using a dietary supplement questionnaire. Hepatic steatosis was evaluated with hepatic steatosis index (HSI). Weighted multivariable regression analysis, subgroup analysis, and interaction analysis were conducted to explore the independent relationship between probiotic exposure and hepatic steatosis. The restricted cubic spline (RCS) was used to analyze the curve association between yogurt and hepatic steatosis. Results： A total of 7891 participants were included in the study represented 146.7 million non-institutionalized residents of the United States, of whom 4322 (54.77%) were diagnosed with hepatic steatosis. Multivariable logistic regression showed probiotic exposure had significantly inverse associations for hepatic steatosis (OR = 0.84, 95% CI: 0.72–0.97, P=0.02) after adjusting for all covariates. Once more, the independent relationship between probiotic exposure and hepatic steatosis was verified by subgroup analysis and interaction analysis. The restricted cubic spline model demonstrated a robust J-shaped link between yogurt and hepatic steatosis, revealing a significant decrease in risk within the lower range of yogurt, which attained the lowest risk close to 0.4 cup. Conclusions: These results suggested that probiotic exposure may have beneficial effects for hepatic steatosis, along with a J-shaped relationship between yogurt and hepatic steatosis. This study recommends that adults take half a cup of yogurt daily. Further research is required to identify the mechanistic relationships between probiotics exposure and hepatic steatosis.